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Magnetic resonance imaging: A biomarker for cognitive impairment in Parkinson's disease?

Lookup NU author(s): Dr Gordon Duncan, Dr Michael FirbankORCiD, Professor John O'Brien, Professor David Burn


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Dementia is a frequent and disabling complication of Parkinson's disease (PD). Clinicians and researchers lack a biomarker capable of tracking the structural and functional changes that underlie the evolution of cognitive dysfunction in PD. Magnetic resonance imaging (MRI) has been adopted as a biomarker in natural history and interventional studies of Alzheimer's disease (AD) and amnestic mild cognitive impairment (MCI), but its utility as a biomarker for PD and Parkinson's disease dementia (PDD) is unclear. In this review, the authors summarize the studies that have used MRI to investigate cognitive decline in PD, outline limitations of those studies, and suggest directions for future research. PD dementia is associated with extensive cortical atrophy, which may be quantified with structural MRI. More promisingly, patterns of atrophy may be present in those who have PD with MCI (PD-MCI). Subcortical white matter tract degeneration is detectable early in the disease with diffusion tensor imaging and may precede changes observed on conventional structural MRI. Although less well studied, other MR techniques, such as functional MRI, MR perfusion imaging with arterial spin labeling, and MR spectroscopy, have demonstrated differences in activation and metabolism between PD and PDD. In this review, the ability to compare studies was limited by the heterogeneity of study populations, cognitive testing methods, and imaging protocols. Future work should adopt agreed scan protocols, should be adequately powered, and should use carefully phenotyped patients to fully maximize the contribution of MRI as a biomarker for PDD

Publication metadata

Author(s): Duncan GW, Firbank MJ, O'Brien JT, Burn DJ

Publication type: Review

Publication status: Published

Journal: Movement Disorders

Year: 2013

Volume: 28

Issue: 4

Pages: 425-438

Print publication date: 28/02/2013

ISSN (print): 0885-3185

ISSN (electronic): 1531-8257


DOI: 10.1002/mds.25352